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Wednesday, October 1, 2008

Sex addict…or the effects of Californication?

I read recently that the actor David Duchovny has checked himself into rehab for the treatment of a sex addiction. I must admit that I had a good belly laugh with that one.

I have never met a sex addict. I have however met a slew of men who claimed the disease of sex addiction after being busted for infidelity. I’ve also met many wives who clung desperately to the belief that the reason for their husband’s habitual failure to keep his dick in his pants was an addiction to sex beyond his control.

I have no idea if this is what Mr. Duchovny’s wife believes. I have never met her and I have not seen any interviews in which she expressed an opinion on her husband’s supposed addiction. I also actually like them both as actors and I wish them well in their attempts to reconstitute their marriage. But if Mr. Duchovny does indeed have a sex addiction, I would be fascinated to read the scholarly monographs on this diagnosis.

Psychologists have long disagreed over whether 'sex addiction' is a legitimate disorder. 1970’s clinicians influenced the inclusion of sex addiction in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). But by 1994, sex addiction had been dropped from the DSM, as researchers argued persuasively that only substances, not behavior, could be addictive. The issue however remains unresolved.

Ever since homosexuality was first included and then removed from the DSM systems, psychological researchers have remained wary of pathologizing human sexual behavior. And this for good reason – it is very difficult to tease out concerns about morality when discussing the topic of sex. In the current version of the DSM, sexual disorders are classified in three categories: sexual dysfunctions, paraphilias, and gender identity disorder.

Sexual dysfunctions represent impairment in normal sexual functioning, such as the inability to achieve an erection, reach orgasm, or experience pain-free intercourse (e.g., vaginismus), in the absence of a medical basis, and with a level of distress that hinders the person's everyday functioning.

One problem with this category of ‘dysfunction’ is that the manual does not indicate how long a problem should endure before it crosses over into dysfunction. Nor does it clarify why level of associated distress is even relevant to diagnosis.

But how can you classify a behavior as a disorder when most of its sufferers are not in the least distressed by their actions? Most individuals with paraphilias do not voluntarily seek psychological help but tend often to be mandated into doing so after getting into legal trouble. I read recently about a man who inserted his penis into the hole in a park bench. Chances are he would have continued to engage in this activity had his member not gotten stuck, requiring rescue by paramedics.

Finally, the category of gender identity disorder includes those individuals commonly referred to as transsexuals, who express a persistent desire to live and be accepted as a member of the opposite sex. Think Isis on the most recent version of ANTM.

Which all brings me back to Mr. Duchovny and his alleged sex addiction. The notion of addiction implies an inability to control behavior, a tendency to continue engaging in the behavior in spite of negative consequences, and a compulsion to spend inordinate amounts in pursuit of the activity. Think gambling. Or Amy Winehouse.

I find it beyond ironic that Mr. Duchovny is the star of a ribald and sexy series called Californication. He plays the protagonist, an irresponsible, constantly horny guy named Hank. I can’t help but wonder how he handled the weekly temptation of pretending to have sex with one beautiful woman after another on camera. I wonder also if his problem might be less sex addiction and more (mere) occupational hazard.